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i CITIES CCY OF EVERETT <br /> PERMIT SERVICES <br /> /!!!!!!!!!:.:1 ETT PERMIT <br /> �� 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1510-013 DATE: t''-'5 ...0 l6 <br /> JOB ADDRESS 10200 19TH AVE SE LEGAL_DESCRIPTION SILVER LAKE GARDEN TRS PER( <br /> DESCRIPTION INSTALL GREASE INTERCEPTOR-COSTCO APN: 28051900101000 <br /> OWNER COSTCO WHOLESALE CORP TENANT COSTCO <br /> 999 LAKE DR CONTRACTOR FERGUSON CONTRUCTION INC <br /> ISSAQUAH WA 98027 PO BOX 80867 <br /> SEATTLE WA 98108 <br /> PHONE 4253138100 <br /> PHONE 2067673810 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE Na OF UNITS SERVICE ORDER NO. APPLICATION NO <br /> 0.00 <br /> SETTER INSTALLATION DATE BY <br /> METER NO. SIZE SI BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. _. #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND MODEL NO. <br /> METER ISTALLATION DATE BY <br /> -r.',�n '''''1. rti <br /> '_ <br /> WATER ON OFF LOCKED OUT BY TSG '� I''D <br /> h-i <br /> REMARKS. --4-1r:t C -r :.r...-7)Cf _-.r-+:::0: x ., <br /> yrTLr_-)::q...,t C":7 C::' C"7 C— <br /> i .' <br /> rri I -y G'3 <br /> SEWER SERVICE I 1A l ! <br /> � <br /> r_;7 <br /> I <br /> 1-...:) <br /> PERMIT NO. SP-16377 PERMIT TYPE ALTERATION ic "F•ID NO. I e I-p•.Cr, <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the Cityjl#,Cet-p EMC 14. 2 n 7 .. <br /> r_3.7 4 8 Cf t.1 -C-fir.i_•3^:7 <br /> C7 C:_.r•J <br /> - <br /> -iCJr_ 4 <br /> to <br /> INSPECTED EIS ` �__. DATE r /'�62_1 0I--`C+ <br /> \,.._ <br /> l FEES <br /> I <br /> Sewer Utility Fee $30.00 <br /> TOTAL FEES $30.00 <br /> PERMIT NUMBER U1510-013 <br /> ADDRESS COPY <br />